Centene is an insurer that offers individual health insurance under its Ambetter brand in 15 states.
The lawsuit outlines a number of instances where Ambetter enrollees have had difficulty finding a doctor, have had to travel for health care, have been denied care that they thought was covered and in-network, or have relied on...National News
UnitedHealth Group reported fourth quarter and full year 2017 results reflecting continued broad-based growth and strengthened operating performance across the enterprise.
NASDAQ reports higher revenues, strength in both its segments, UnitedHealthcare and Optum, and membership growth led to the performance.
David S. Wichmann,...
The Medicare Payment Advisory Commission (MedPAC) voted 14-2 to in favor of killing the Merit-based Incentive Payment System (MIPS) and replacing it with an alternative model of reimbursement.
MedPAC Chairman Francis "Jay" Crosson of Palo Alto, California, said he wished the commission had made its recommendation sooner, but it had...
Trump administration to permit requirement to work if states seek it.
The Arizona Daily Star reports Arizona is one of 10 states that have submitted applications to add work requirements for the government health insurance program for low-income people.
The state’s Medicaid program, called the Arizona Health Care Cost Containment...National News
BPCI Advanced will qualify as an Advanced Alternative Payment Model (APM) under the Quality Payment Program.
BPCI Advanced will operate under a total-cost-of-care concept, in which the total Medicare fee for services (FFS) spending on all items and services furnished to a BPCI Advanced Beneficiary during the Clinical Episode,...National News
Narrow networks are already the norm in Medicare Advantage and ACA exchange plans.
Narrow networks are open only to providers and hospitals that agree to meet specific quality requirements and likely accept lower reimbursements. The theory is to offer higher value care at a lower cost.
Payers and employers using narrow networks...National News
The new rules could make it easier for small businesses to band together and create health insurance plans that would be exempt from many of the consumer protections mandated by the Affordable Care Act.
The move permits "association health plans". The Labor Department said:
By joining together employers may reduce administrative...Arizona News
Alarming number of overdose deaths in Arizona creates call for action.
The Arizona Republic reports at least 716 people in Arizona are believed to have died of opioid-related overdoses during a six-month stretch of 2017, far exceeding previous death statistics that span an entire calendar year, according to the state health...National News
Rosebud, Flandreau and Sisseton-Wahpeton Sioux tribes allege they sold addictive drugs without warning of their dangers.
The tribes have targeted drug makers Purdue Pharma, Teva Pharmaceuticals, Allergen PLC and distributors McKesson Corp., Cardinal Health Inc. and AmerisourceBergen Corp.
The tribes' allegations align with those...National News
The new estimate was included in a letter the budget office sent Friday to Sen. Orrin Hatch, R-UT.
An Associated Press story in The Star Tribune reports the CBO now says a Senate bill adding five years of financing to the program would cost $800 million. Previously, the analysts estimated it would cost $8.2 billion.
The lower cost...Arizona News
Requests filed with Arizona Department of Insurance range from 12 to 19 percent increases.
The Phoenix Business Journal reports the carriers' requests are for their health plans that are not part of the Affordable Care Act's health insurance marketplace.
Effective April 1, All Savers Insurance Co. is requesting a 12.6 percent...Arizona News
The joint venture will operate physical therapy centers and acute inpatient hospitals in Arizona.
Banner Health will be the majority owner; Select Medical will serve as managing partner.
In the agreement, the combined outpatient rehabilitation services will include 26 Select Physical Therapy centers currently operating in the...Arizona Comings & Goings
Rob Neely was promoted to VP, provider networks at Health Net Federal Services at Centene. He was formerly VP, provider relations and network operations, Arizona Health Plans....Arizona Comings & Goings
Richard "Rich" Mutarelli is the new chief financial officer for Maricopa Integrated Health System, replacing Kathy Benaquista, who retired in December.
Mutarelli was formerly the CEO of Heart of Florida Health Center, a system of FQHCs in Central Florida.Arizona Comings & Goings
Amy Klawitter was promoted to VP of key account sales and account management for UnitedHealthcare of Arizona and New Mexico. She succeeds Mark Olson who serves in the same capacity in Colorado.Arizona Comings & Goings
Lori Cummins is now the director of post-acute alignment, academic division at Banner Health. She was formerly the regional sales director for Preferred Homecare/Lifecare Solutions....Arizona Comings & Goings
Sylvia Badilla and Angelica Moraga are now part of P3 Health Partners. Badilla, formerly contracts manager at HealthNet, is now manager of contracting. Moraga is now a provider contract specialist.National News
In an increasingly common business arrangement, owners of nursing homes outsource a wide variety of goods and services to companies in which they have a financial interest or that they control.
According to an analysis of nursing home financial records by Kaiser Health News, nearly three-quarters of nursing homes in the United States...National News
Published in Health Affairs this week, authors test a theory that Medicaid expansion prevents hospital closures.
Hospitals in states that expanded Medicaid under the Affordable Care Act were about six times less likely to close than hospitals in non-expansion states. In AHA Today, we learn Medicaid expansion was associated with...National News
A major shift in the 50-year-old program, the guidelines will set the conditions for allowing states to add work requirements to their Medicaid programs, bringing a conservative twist to the health insurance program for the poor.
The Hill reports the changes represent the vision of Seema Verma, the administrator of the Centers for...Arizona News
Dr. Bob England, veteran public health officer, to leave the end of January.
England's entire career has been in public health. He was the state epidemiologist for the Arizona Department of Health Services prior to his 12 years with the Maricopa County Department of Public Health.
In the Phoenix Business Journal report, Dr...